Nutrition support is essential in children with cancer, including those
undergoing bone marrow transplant (BMT), to reduce the risk of
malnutrition and associated deleterious outcomes. Enteral nutrition is
more commonly provided via nasogastric than gastrostomy tubes due to
safety concerns with the latter in immunocompromised children. This
systematic review investigated the incidence and type of complications
and outcomes in pediatric cancer patients fed by gastrostomy. Across
studies, 54.6% of children developed ≥1 complication, of which 76.6%
were classified as minor, 23.4% major. The most frequent complications
included inflammation (52% of episodes), infection (42.1%), leakage
(22.3%) and granuloma (21%). Evidence regarding infection rates in
cancer/BMT patients compared with other disease states was inconclusive.
Gastrostomy feeding was associated with improvement or stabilization of
nutritional status in 77-92.7% of children. Gastrostomy feeding in this
population is safe and effective in stabilizing or improving nutritional
status throughout treatment. Complications are frequent but mostly
minor.
Systematic review of gastrostomy complications and outcomes in pediatric cancer and bone marrow transplant
